Imad Hassan, Yasir Ged
Saud bin Abdulaziz University for Health Sciences, Department of Medicine 1443, King Abdulaziz Medical City, King Fahad National Guard Hospital, PO Box 22490, Riyadh 11426, Kingdom of Saudi Arabia.
Medical Officer, Department of Medicine, National Ribat University Hospital, Khartoum, Sudan.
Pan Afr Med J. 2015 Jun 24;21:154. doi: 10.11604/pamj.2015.21.154.5404. eCollection 2015.
This study aims at describing the epidemiological and clinical characteristics, severity, reversibility testing and response to treatment using simple spirometry in asthmatic patients attending a model specialized Asthma Care Center.
Eligible subjects must have a suggestive clinical picture and confirmed by spirometry to have a 12% plus 200ml absolute increase in FEV1 either by reversibility testing or after a therapeutic trial with inhaled and/or oral steroid therapy. Budesonide-Formoterol Turbohaler was used for reversibility testing and for maintenance therapy with or without the addition of oral prednisolone.
One hundred and nineteen patients were eligible for the study. Age ranged between 10 -70 years. One hundred and thirteen patients (95.0%) had an FEV1 less than 80% of predicted. One hundred and five patients (88.2%) had reversibility testing of whom 72 (68.6%) had a significant reversibility. Sixty two patients (52.1%) were prescribed Budesonide-Formoterol Turbohaler only whilst 57 were prescribed both Budesonide-Formoterol Turbohaler and oral prednisolone. Patients were reviewed after a mean of 14.9 days (range 6.0-28.0). Seventy two patients (60.5%) had increased their FEV1 to more than 80% of their predicted value. By logistic regression analysis, predicted FEV1 at baseline was a significant negative predictor of a complete response.
Most patients had abnormal spirometry with more than half having an FEV1 that is 60% or less of their predicted normal reading. Reversibility testing using Budesonide-Formoterol Turbohaler confirmed the fast onset of action of its Formoterol component and helped in cutting the cost of this test. The majority improved with treatment with 60% normalizing their spirometry highlighting the feasibility and applicability of specialized asthma care centers in resource-poor countries.
本研究旨在描述在一家模范专业哮喘护理中心就诊的哮喘患者的流行病学和临床特征、严重程度、可逆性测试以及使用简易肺量计进行治疗的反应。
符合条件的受试者必须有提示性的临床症状，并通过肺量计确认，通过可逆性测试或在吸入和/或口服类固醇治疗的治疗试验后，FEV1有12%加200毫升的绝对增加。布地奈德-福莫特罗都保用于可逆性测试和维持治疗，可加用或不加用口服泼尼松龙。
119名患者符合研究条件。年龄在10至70岁之间。113名患者（95.0%）的FEV1低于预测值的80%。105名患者（88.2%）进行了可逆性测试，其中72名（68.6%）有显著的可逆性。62名患者（52.1%）仅被处方使用布地奈德-福莫特罗都保，而57名患者同时被处方使用布地奈德-福莫特罗都保和口服泼尼松龙。平均14.9天（范围6.0 - 28.0）后对患者进行复查。72名患者（占60.5%）的FEV1增加到超过其预测值的80%。通过逻辑回归分析，基线时预测的FEV1是完全反应的显著负预测因子。
大多数患者的肺量计检查结果异常，超过一半患者的FEV1为其预测正常读数的60%或更低。使用布地奈德-福莫特罗都保进行的可逆性测试证实了其福莫特罗成分起效迅速，并有助于降低该测试的成本。大多数患者经治疗后病情改善，60%的患者肺量计检查结果恢复正常，突出了资源匮乏国家专业哮喘护理中心的可行性和适用性。
